Notice of Privacy Practices

At Barreto Family Medicine, we understand that medical information about you and your health is highly personal. We are committed to protecting medical information about you. We create a record of the care and services you receive from our practice to provide you with quality care and to comply with certain legal requirements.

This Notice of Privacy Practices (“Notice”) applies to all of the records of your care generated by this practice. This Notice will tell you about the ways in which we may use and disclose your Protected Health Information (PHI). We also describe your rights and certain obligations we have regarding the use and disclosure of medical information.

1. How We May Use and Disclose Your Health Information

The following categories describe different ways that we are permitted to use and disclose health information without your specific authorization:

• For Treatment: We may use medical information about you to provide you with medical treatment or services. We may disclose medical information about you to doctors, nurses, technicians, medical students, or other personnel who are involved in taking care of you (e.g., transmitting a prescription to your pharmacy).
• For Payment: As a Direct Primary Care (DPC) practice, Barreto Family Medicine does not directly bill third-party insurance payers. However, we may use and disclose medical information so that the treatment and services you receive can be billed to and collected from you or your designated financial account. If you request superbills to submit to an out-of-network insurer, we will provide the necessary PHI on that document.
• For Health Care Operations: We may use and disclose medical information about you for practice operations. These uses and disclosures are necessary to run the practice efficiently and ensure all our patients receive quality care (e.g., quality assessment, training, audits).
• As Required By Law: We will disclose medical information about you when required to do so by federal, state, or local law.
• Public Health Risks: We may disclose medical information about you for public health activities, such as to prevent or control disease, injury, or disability, or to report suspected abuse or neglect.

2. Your Privacy Rights

You have the following rights regarding medical information we maintain about you:

• Right to Inspect and Copy: You have the right to inspect and copy medical information that may be used to make decisions about your care. Normally, this includes medical and billing records.
• Right to Amend: If you feel that medical information we have about you is incorrect or incomplete, you may ask us to amend the information. You must provide a reason that supports your request.
• Right to an Accounting of Disclosures: You have the right to request a list of certain disclosures we made of medical information about you.
• Right to Request Restrictions: You have the right to request a restriction or limitation on the medical information we use or disclose about you for treatment, payment, or health care operations. Note: We are not required to agree to your request, except under specific circumstances involving out-of-pocket payments.
• Right to Request Confidential Communications: You have the right to request that we communicate with you about medical matters in a certain way or at a certain location (e.g., only calling you at work).

3. Changes to This Notice

We reserve the right to change this Notice. We reserve the right to make the revised or changed Notice effective for medical information we already have about you as well as any information we receive in the future. The current Notice will be available within our office and on our website.

4. Complaints

If you believe your privacy rights have been violated, you may file a complaint with our practice or with the Secretary of the Department of Health and Human Services. To file a complaint with our practice, please contact us at the address below. You will not be penalized for filing a complaint.

Privacy Officer
Barreto Family Medicine
71 Fair Street
Otego, NY 13825
Phone: (607) 988-0105
Email: barretofamilymedicine@gmail.com